Cross Pit Lane Dental Surgery

We carried out this announced comprehensive inspection on 2 October 2023 under section 60 of the Health and Social Care Act 2008 as part of our regulatory functions.

We planned the inspection to check whether the registered practice was meeting the legal requirements in the Health and Social Care Act 2008 and associated regulations.

The inspection was led by a Care Quality Commission (CQC) inspector who was supported by a specialist dental advisor.

To get to the heart of patients’ experiences of care and treatment, we always ask the following 5 questions:

• Is it safe?
• Is it effective?
• Is it caring?
• Is it responsive to people’s needs?
• Is it well-led?

These questions form the framework for the areas we look at during the inspection.

Our findings were:

• The dental clinic appeared clean and well-maintained.
• The practice had infection control procedures which reflected published guidance.
• The segregation of clinical waste required improvement.
• Staff knew how to deal with medical emergencies. Appropriate medicines and life-saving equipment were available.
• The practice had systems to manage risks for patients, staff, equipment and the premises. Some policies did not take account of changes in the practice and some documents lacked required details.
• The servicing of some equipment was not in date.
• Safeguarding processes were in place and staff knew their responsibilities for safeguarding vulnerable adults and children.
• The practice had staff recruitment procedures which reflected current legislation.
• Dental care was provided in line with recognised guidance, but some antibiotic prescribing did not mirror updated guidelines.
• There was no system in place for staff to receive safety alerts and product recall notices.
• Patients were treated with dignity and respect. Staff took care to protect patients’ privacy and personal information.
• Staff provided preventive care and supported patients to ensure better oral health.
• The appointment system worked efficiently to respond to patients’ needs.
• The frequency of appointments was agreed between the dentist and the patient, giving due regard to National Institute of Health and Care Excellence (NICE) guidelines.
• Systems processes to help drive improvement were not always applied.
• Patient treatment records were kept in line with recognised guidance, but all required information was not consistently recorded.
• Complaints were dealt with positively and efficiently.
• The practice had information governance arrangements.

Background

Cross Pit Lane Dental Surgery is in Rainford, St Helens and provides private dental care and treatment for adults and children.

Access to the practice is via a small porch which has a step up to it, and then into the main front door. It may not be suitable therefore, for people who use wheelchairs and those with pushchairs. Car parking spaces are available near the practice. The practice has made reasonable adjustments to support patients with access requirements.

The dental team includes 1 dentist, 2 dental nurses, one of whom deals with practice management, 1 dental hygienist, and a receptionist. The practice has 2 treatment rooms.

During the inspection we spoke with the principal dentist, 2 dental nurses, and the receptionist. We looked at practice policies, procedures and other records to assess how the service is managed.

The practice is open from 9am to 5pm Monday to Friday.

We identified a regulation the provider was not complying with. They must:

• Establish effective systems and processes to ensure good governance in accordance with the fundamental standards of care

Full details of the regulation the provider was not meeting are at the end of this report.

There were areas where the provider could make improvements. They should:

• Implement processes and systems for seeking and learning from patient feedback with a view to monitoring and improving the quality of the service.
• Take action to ensure clinicians take into account the guidance provided by the College of General Dentistry when completing dental care records.
• Take action to ensure clinicians record in the patients’ dental care records or elsewhere the reason for taking X-rays, a report on the findings and the quality of the image in compliance with Ionising Radiation (Medical Exposure) Regulations 2017.
• Implement an effective system of audit, for prescribing of antibiotic medicines, X-ray quality and reporting and completion of dental treatment records, taking into account all relevant guidance.